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| Coagulation function and hemorheology status of pregnant women with unexplained recurrent miscarriage and the therapeutic effect of the pregnant women by low molecular weight heparin |
| 1.Wuhan Children’s Hospital Affiliate to Tongji Medical College, Huazhong University of Science & Technology (Wuhan Maternal and Child Health Care Hospital), Wuhan, Hubei Province, 430016；2.The Eight Hospital of Wuhan, Hubei Province |
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Abstract To investigate the coagulation function and hemorheology status of women with unexplained recurrent miscarriage (URSA), and to study the therapeutic effect of the pregnant women by low molecular weight heparin (LMWH).Methods: A total of 96 pregnant women with URSA were selected and randomly divided into group A and group B (48 cases in each group) from January 2019 to June 2020.The women in group B were given conventional fetal protection treatment, and the women in group A were given LMWH except to conventional fetal protection treatment.The values of coagulation function indexes, such as D-dimer (DD), prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB), and the values of hemorheological parameters, such as high-cut and low-cut whole blood apparent viscosity, whole blood reduced viscosity, and plasma viscosity, of the patients in group A and B before pregnancy (baseline period), and during 6 and 8 gestational weeks were detected, and which also were compared with those of 48 healthy pregnant women (in group C).Results: The values of D-D, FIB, whole blood apparent viscosity, whole blood reducing viscosity, and plasma viscosity of the women in group A and group B before pregnancy, and during 6 and 8 gestational weeks were significantly higher than those of the women in group C, but the values of PT, TT and APTT of the women in group A and group B were significantly lower (all P＜0.05).The values of D-D, whole blood apparent viscosity, whole blood reductive viscosity, and plasma viscosity of the women in group C during 6 and 8 gestational weeks was significantly higher than those before pregnancy, but the FIB value of the women in group C during 6 and 8 gestational weeks was significantly lower.The values of PT, TT, APTT, whole blood apparent viscosity, whole blood reductive viscosity, and plasma viscosity of the women in group A and group B during 6 and 8 gestational weeks had increased significantly, and the values of D-D, FIB, whole blood apparent viscosity, whole blood reductive viscosity, blood plasma viscosity of the women in group A were significantly lower than those of the women in group B, but the values of PT, TT and APTT of the women in group A were significantly higher than those of the women in group B (all P＜0.05).The success rate of pregnancy (89.6%) of the women in group A was significantly higher than that (77.1%) of the women in group B (P＜0.05).LMWH related adverse reactions had occurred in 10.4% of the women in group A during treatment, mainly included local pain and ecchymosis after LMWH injection.Conclusion: Coagulation and hemorheology of the pregnant women are obviously abnormal before pregnancy and during the first trimester of pregnancy.LMWH can improve the coagulation function and hemorheological status of these women, and can increase their pregnancy success rate.The coagulation function and adverse reactions of the women should be closely monitored during treatment.
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